# Association Between Severity of COVID-19 Infection and Persistent Dyspnea in Recovered Adults: A Cross-Sectional Study

**Authors:** Atif Saeed, Marium Nadeem Khan, Momina Kamran, Shivam Singla, Sri Teja Chikkala, Moeed Akbar Malik, Joseph Benjamin Baidoo, Farhan Ullah, Bhavna Singla, Sara Ali, Fatima Alam

PMC · DOI: 10.7759/cureus.85666 · 2025-06-09

## TL;DR

This study finds that the severity of a person's initial COVID-19 infection is linked to more persistent and severe shortness of breath after recovery.

## Contribution

The study provides empirical evidence of a strong correlation between initial infection severity and post-COVID dyspnea.

## Key findings

- Higher severity of initial infection correlates with more severe persistent dyspnea (r = 0.521, p < 0.05).
- Patients receiving oxygen therapy had higher clinical scores than those who did not (p = 0.01).
- Regression analysis showed a strong association between clinical condition changes and dyspnea (β = 0.521, p < 0.001).

## Abstract

Introduction

The COVID-19 pandemic has led to a high number of survivors with persistent symptoms, such as dyspnea, long after recovery. It is important to understand the association between the severity of the initial COVID-19 infection and the persistence of dyspnea to guide patient management and rehabilitation planning.

Methods

This cross-sectional analysis involved adult patients who had recovered from laboratory-confirmed COVID-19 infection. Patients were stratified into groups by the severity of their acute infection (mild, moderate, severe) based on the WHO Clinical Progression Scale. Persistent dyspnea was measured with a validated dyspnea scale. Statistical analysis was conducted to examine the association between COVID-19 severity and severity of dyspnea, adjusting for potential confounders.

Results

A total of 385 individuals took part in the study, where 217 people (56%) fell within the 30 to 39 years age bracket, while female participants constituted 52% (200 individuals). The respondents were primarily widowed people who had received secondary education (n = 119, 31%, and n = 118, 31% respectively). A total of 141 participants were current smokers, while 145 participants reported never smoking. Among the study participants, 73 experienced asthma (19%), and hypertension affected 68 individuals (18%). The COVID-19 severity of patients spanned from mild (n = 144, 37%) to critical (n = 78, 20%), and 51% of patients received hospital care (n = 197). Research findings indicated that dyspnea symptoms and advancement in the disease are closely linked (r = 0.521, p < 0.05). People who got oxygen therapy had higher clinical scores than those who did not (p = 0.01). When comparing the ICU patients to other patients, no important differences were noticed (p = 0.05). Recovery was felt very minimally in the results. According to regression analysis, changes in the patient’s clinical condition were highly associated with dyspnea, as shown by a β value of 0.521 and p < 0.001.

Conclusion

The intensity of COVID-19 infection strongly correlates with both the enduring nature and severity of dyspnea in adults who have recovered from the disease. Post-COVID follow-up and rehabilitation programs require strong evidence behind them to support patients who have experienced severe COVID-19 infections.

## Linked entities

- **Diseases:** COVID-19 (MONDO:0100096), asthma (MONDO:0004979)

## Full-text entities

- **Diseases:** asthma (MESH:D001249), COVID-19 (MESH:D000086382), Post-COVID (MESH:D000094024), hypertension (MESH:D006973), Dyspnea (MESH:D004417), infection (MESH:D007239)
- **Chemicals:** oxygen (MESH:D010100)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12241829/full.md

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Source: https://tomesphere.com/paper/PMC12241829